Food gives you energy and helps your body repair itself. Food is broken down in your stomach and intestines. Your blood picks up nutrients from the digested food and carries it to all your cells. These cells take nutrients from your blood and put waste products back into the bloodstream. Healthy kidneys work constantly to remove wastes from blood. The wastes leave the body through urination and bowel movements.

In a patient whose kidneys have stopped working, PD removes wastes from the blood daily. The amount of wastes can be reduced by watching food and drink intake. A good meal plan can improve dialysis and health. Your clinic has a dietitian to help you with plan meals. Dietitians specialize in food and nutrition. A dietitian with special training in care for kidney health is called a renal dietitian.

Fluids

During the first few weeks that you are on PD, it is recommended that you limit your fluids to a moderate amount (8 cups or 64 ounces per day). Once your dialysis is going well and the edema or swelling is gone, you’ll be encouraged to drink more fluids. If you notice your blood pressure is high or you are retaining extra fluid, you may need to cut back on fluids and sodium or adjust the strength of your dialysis solution. Contact your PD nurse or dietitian if you have further questions.

Sodium

Too much sodium in your diet can be harmful because it causes your blood to hold fluid. The extra fluid raises your blood pressure and puts a strain on your heart and kidneys. Sodium is found in salt and most foods. Canned foods and frozen dinners usually contain large amounts of sodium. Too much sodium makes you thirsty. But if you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure. To lower your sodium intake, try to eat fresh foods that are naturally low in sodium and look for products labeled low sodium. For additional information on managing your sodium intake, consult your renal dietitian.

Phosphorus

Phosphorus is a mineral found in many foods. If you have too much phosphorus in your blood, it takes calcium from your bones. Losing calcium will make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Foods like milk, cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus. Your renal dietitian will give you more specific information regarding phosphorus.

You will probably need to take a phosphate binder to control the phosphorus in your blood between dialysis sessions. These medications act like sponges to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into the blood. Instead, it is passed out of the body in the stool.

Protein

Before you were on dialysis, your doctor may have told you to follow a low protein diet. Being on dialysis changes this. Most people on dialysis are encouraged to eat as much high-quality protein as they can. The better nourished you are, the healthier you will be. Protein helps you keep muscle and repair tissue. You will also have greater resistance to infection and recover from surgery more quickly.

You will know if you are eating enough protein by your monthly blood test. Your albumin level is the best indicator. It needs to be at least 3.5, preferably over 4.0. If this level drops, you will usually feel more tired and weak. This also puts you at greater risk for developing an infection.

What About Protein Supplements?

It is recommended that all people on PD be on a protein supplement as part of their diet. This will assist you to meet your total protein needs. If your albumin is low, a protein supplement is even more important. Even if your protein level is good, a supplement can help it stay that way. It’s like insurance for your body – you hope you don’t need to “cash in” on it, but when you do need it, you are happy you have it. Protein supplements come as liquids, powders, and bars. Recommended choices can be provided by your dietitian.

Calories

Calories provide energy for your body. If your doctor recommends it, you may need to cut down on the calories you eat. A dietitian can help you plan ways to cut calories in the best possible way.

Some people on dialysis need to gain weight by adding calories. Vegetable oils like olive, canola, and safflower are good sources of calories. Use them generously on breads, rice, and noodles.

Butter and margarines are also rich in calories, but these fatty foods can also clog your arteries. Use them less often. Soft margarine that comes in tubs is better than stick margarine. Vegetable oils are the healthiest way to add fat to your diet if you need to gain weight.

Hard candy, sugar, honey, jam, and jelly provide calories and energy without clogging arteries or adding other things that your body does not need. If you have diabetes, be very careful about eating sweets. A dietitian's guidance is very important for people with diabetes.

Will I Gain Weight on PD?

The PD solutions you will be using contain dextrose, a type of sugar. The higher the dextrose amount, the more calories from sugar your body absorbs. Your dialysis may give you as much as 400 to 600 extra calories each day, depending on which solutions you use. To avoid excess weight gain, limit your intake of high sugar and high fat foods. Also, consider regular exercise such as walking. Always consult your doctor before starting an exercise program.

Should I Take Vitamins and Minerals?

Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Your doctor may prescribe a multi-vitamin and mineral supplement specially formulated for people with kidney disease.

Do not take vitamins that you can buy off the store shelf. They may contain vitamins or minerals that are harmful to you.

Keep Track of Test Results

Your doctor will order regular blood tests. You will find that keeping track of your test results helps you see how your treatment is working. Your dietitian will provide you with copies of your lab reports and explain them to you. When you learn how to read your reports, you will see how the foods you eat affect your kidneys. Talk with your dietitian about making healthier food choices. Remember that you are the most important member of your health care team.